Tang Xiangfeng, Fang Jianpei, Yu Jie, Li Zhiguang, Chen Jing, Sun Xin, Zhu Yiping, Hu Shaoyan, Qin Maoquan, Tang Yongmin, Luan Zuo
Navy General Hospital, Beijing, China.
Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Pediatr Transplant. 2018 Feb;22(1). doi: 10.1111/petr.13090. Epub 2017 Dec 14.
This multicenter retrospective study included 184 children with malignant and non-malignant diseases who underwent UCBT between January 1998 and August 2012. The malignant disease group included 101 children with ALL, AML, CML, JMML, and MDS, and the non-malignant disease group included 83 children with PID, β-thalassemia, IMD BMF, and HLH. The median duration to neutrophil and platelet engraftment was 16 and 35 days in the malignant disease group vs 15 and 38 days in the non-malignant disease group. The cumulative incidence of grade II-IV aGVHD and cGVHD was 25.6% and 13.5% in the malignant disease group vs 19.7% and 11.1% in the non-malignant disease group, respectively. The median duration and cumulative incidence of neutrophil and platelet engraftment, and the cumulative incidence of grade II-IV aGVHD and cGVHD were similar between the two groups. Of the 184 pediatric patients, 114 patients survived during a median follow-up period of 14 months (range 4-138). The 5-year OS and DFS were not statistically different between the two groups (56.3% and 46.1% in malignant disease group vs 68.5% and 52.8% in non-malignant disease group). The above results indicate that UCB is a viable source for HSCT for children with malignant or non-malignant diseases, especially in urgent cases.
这项多中心回顾性研究纳入了1998年1月至2012年8月期间接受脐血移植(UCBT)的184例患有恶性和非恶性疾病的儿童。恶性疾病组包括101例患有急性淋巴细胞白血病(ALL)、急性髓系白血病(AML)、慢性髓系白血病(CML)、幼年型粒单核细胞白血病(JMML)和骨髓增生异常综合征(MDS)的儿童,非恶性疾病组包括83例患有原发性免疫缺陷病(PID)、β地中海贫血、重症联合免疫缺陷病(IMD)、噬血细胞性淋巴组织细胞增生症(HLH)的儿童。恶性疾病组中性粒细胞和血小板植入的中位时间分别为16天和35天,而非恶性疾病组分别为15天和38天。恶性疾病组Ⅱ-Ⅳ级急性移植物抗宿主病(aGVHD)和慢性移植物抗宿主病(cGVHD)的累积发生率分别为25.6%和13.5%,而非恶性疾病组分别为19.7%和11.1%。两组中性粒细胞和血小板植入的中位时间、累积发生率以及Ⅱ-Ⅳ级aGVHD和cGVHD的累积发生率相似。在184例儿科患者中,114例患者在中位随访期14个月(范围4-138个月)内存活。两组的5年总生存率(OS)和无病生存率(DFS)无统计学差异(恶性疾病组为56.3%和46.1%,非恶性疾病组为68.5%和52.8%)。上述结果表明,脐血是患有恶性或非恶性疾病儿童进行造血干细胞移植(HSCT)的可行来源,尤其是在紧急情况下。